The authors describe three patients who suffered penetrating wounds of the liver with low-velocity bullets. They treated the wounds successfully with hepatostomy tubes which were kept on suction for 7 to 12 days. They did choledochostomies on two of the patients. Results with these patients, and others they have treated, have convinced them that the hepatostomy tube, as opposed to liver resection, is indicated for this type of low-velocity wound or for single stab wounds. Choledochostomy is indicated only in the more severe instances of liver injury, those involving the porta hepatis, or in those requiring major hepatic resection.
Pickleman J, Block GE. Adjuncts to the Operative Management of Penetrating Liver Injuries. Arch Surg. 1973;106(4):402-406. doi:10.1001/archsurg.1973.01350160024004